Coronavirus Sars-CoV-2/Covid-19 Megathread

[Iormlund]

Not just the tests. I'm baffled that you have to go to the doctor/hospital to get tested. They should come to you so as not to risk spread. Don't you guys have hotlines provided by your insurer/network/government?

[dps]

Not just the tests. I'm baffled that you have to go to the doctor/hospital to get tested. They should come to you so as not to risk spread. Don't you guys have hotlines provided by your insurer/network/government?

Doctors mostly quit making house calls in the US by about 1970.

[merithyn]

Not just the tests. I'm baffled that you have to go to the doctor/hospital to get tested. They should come to you so as not to risk spread. Don't you guys have hotlines provided by your insurer/network/government?

That's adorable.

No, friend, we do not. That being said, there's a new pilot program happening out here in the PNW that is effectively bringing home healthcare back. It's been around for around six months and it's barely used.

[Iormlund]

Not just the tests. I'm baffled that you have to go to the doctor/hospital to get tested. They should come to you so as not to risk spread. Don't you guys have hotlines provided by your insurer/network/government?

Doctors mostly quit making house calls in the US by about 1970.

It's not a random doctor. It's a way to lessen the burden on ER resources. We have teams on standby. You call 061 and speak with a doctor on the phone, then he/she can send you one of the teams. They come to your house and assess the case (I've twice ended up riding an ambulance to the hospital).

If you call now with a possible COVID contagion they can send a team prepared to take a sample. Nobody else has to be put at risk.

[merithyn]

Pence is saying any American can be tested. Labs and other experts are flat out saying it's simply not possible to test and process more than 100 tests a day.

I'm sorry, world. The US is going to ruin it for everyone.

The Trump administration is out of touch and only live in their spin echo chamber.

I am baffled by the the test limit.

I think we've set up a lab specifically for this (I think the only other country that did that was China), but the difference between tests done yesterday and today is about 3,000 and it can't just be because of that

Per the CDC labs, they don't have the capacity to run more tests than that. Whatever the testing entails, it takes more resources than they can provide. The goal is to up the amount to 1000 tests per day by some time next month.

We're gonna die.

[merithyn]

Not just the tests. I'm baffled that you have to go to the doctor/hospital to get tested. They should come to you so as not to risk spread. Don't you guys have hotlines provided by your insurer/network/government?

Doctors mostly quit making house calls in the US by about 1970.

It's not a random doctor. It's a way to lessen the burden on ER resources. We have teams on standby. You call 061 and speak with a doctor on the phone, then he/she can send you one of the teams. They come to your house and assess the case (I've twice ended up riding an ambulance to the hospital).

If you call now with a possible COVID contagion they can send a team prepared to take a sample. Nobody else has to be put at risk.

Yeah, that's what this new Dispatch program is. The goal is to minimize actual ER visits for people. It's brand new and isn't paying for itself at all, so who knows if it will ever take off. It's not tied to our 911 systems because they're independently owned and operated so not governmental.

Privatized healthcare FTW!!

[dps]

Not just the tests. I'm baffled that you have to go to the doctor/hospital to get tested. They should come to you so as not to risk spread. Don't you guys have hotlines provided by your insurer/network/government?

Doctors mostly quit making house calls in the US by about 1970.

It's not a random doctor. It's a way to lessen the burden on ER resources. We have teams on standby. You call 061 and speak with a doctor on the phone, then he/she can send you one of the teams. They come to your house and assess the case (I've twice ended up riding an ambulance to the hospital).

If you call now with a possible COVID contagion they can send a team prepared to take a sample. Nobody else has to be put at risk.

Yeah, that's what this new Dispatch program is. The goal is to minimize actual ER visits for people. It's brand new and isn't paying for itself at all, so who knows if it will ever take off. It's not tied to our 911 systems because they're independently owned and operated so not governmental.

Privatized healthcare FTW!!

That sounds even more costly and inefficient than going to the ER, though more convenient (and probably quicker) for the patient.

[merithyn]

Not just the tests. I'm baffled that you have to go to the doctor/hospital to get tested. They should come to you so as not to risk spread. Don't you guys have hotlines provided by your insurer/network/government?

Doctors mostly quit making house calls in the US by about 1970.

It's not a random doctor. It's a way to lessen the burden on ER resources. We have teams on standby. You call 061 and speak with a doctor on the phone, then he/she can send you one of the teams. They come to your house and assess the case (I've twice ended up riding an ambulance to the hospital).

If you call now with a possible COVID contagion they can send a team prepared to take a sample. Nobody else has to be put at risk.

Yeah, that's what this new Dispatch program is. The goal is to minimize actual ER visits for people. It's brand new and isn't paying for itself at all, so who knows if it will ever take off. It's not tied to our 911 systems because they're independently owned and operated so not governmental.

Privatized healthcare FTW!!

That sounds even more costly and inefficient than going to the ER, though more convenient (and probably quicker) for the patient.

Not even close. Seattle has two cars (soon to be three!) with a Nurse Practioner in each one. They're dispatched to an address where they prevent the person from going into the ER for certain things like IV antibiotics, IV fluids, port change-outs, etc. There is a list of things that they can do.

Average time from call to completion is 60 minutes. Average number of calls per car each day is 7.5. It eliminates issues with someone waiting too long for the needed treatments, being exposed to additional illnesses, and allows for a more comfortable environment to be treated.

Cost is around $225 per trip. They charge $275 per trip, plus the added benefit of someone who wouldn't typically be seen calling in, them less likely catching something in the ER, and overall better outcomes for the patients. That leads to fewer costs later down the road.

I'm on a team to determine if it's cost-effective to bring the program to our providers in Utah. Right now, we're doing the cost analysis, which is showing that in actual costs it's not that beneficial, but in the extra costs there's serious potential benefits for both the patients and the insurance company.

[viper37]

That sounds even more costly and inefficient than going to the ER, though more convenient (and probably quicker) for the patient.

For some vulnerable clients (chronical diseases, elderlys, etc), it is better this way, because they will often wait too long before going to the ER and then they require a lot more care.  So, they send nurses at home to check bandages, general healthcare, vital signs, give them meds if need be, etc.

As of now, I don't think doctors will go to your place, but some doctors will make regular visits to retirement homes, private or public.

For covid-19, as of now, there are no special requirements except than to call 811 health hotline (Info-Santé)) to speak with a nurse.  If there's a real risk of infection, they will recommend isolation at first, and may direct you to an hospital that has been advised of your arrivals and general symptoms. 

But since for most people it's just the flu, they simply tell them to stay at home and watch their symptoms.  And that's just fine like this.

[merithyn]

That sounds even more costly and inefficient than going to the ER, though more convenient (and probably quicker) for the patient.

For some vulnerable clients (chronical diseases, elderlys, etc), it is better this way, because they will often wait too long before going to the ER and then they require a lot more care.  So, they send nurses at home to check bandages, general healthcare, vital signs, give them meds if need be, etc.

[crazy canuck]

Not just the tests. I'm baffled that you have to go to the doctor/hospital to get tested. They should come to you so as not to risk spread. Don't you guys have hotlines provided by your insurer/network/government?

Doctors mostly quit making house calls in the US by about 1970.

It's not a random doctor. It's a way to lessen the burden on ER resources. We have teams on standby. You call 061 and speak with a doctor on the phone, then he/she can send you one of the teams. They come to your house and assess the case (I've twice ended up riding an ambulance to the hospital).

If you call now with a possible COVID contagion they can send a team prepared to take a sample. Nobody else has to be put at risk.

Yeah, that's what this new Dispatch program is. The goal is to minimize actual ER visits for people. It's brand new and isn't paying for itself at all, so who knows if it will ever take off. It's not tied to our 911 systems because they're independently owned and operated so not governmental.

Privatized healthcare FTW!!

We have been doing that sort of thing for years here in BC, except it is all tied into the 911 system and is centralized to increase efficiency.

Glad to see the private sector is catching up to single payor innovations 

[dps]

That sounds even more costly and inefficient than going to the ER, though more convenient (and probably quicker) for the patient.

For some vulnerable clients (chronical diseases, elderlys, etc), it is better this way, because they will often wait too long before going to the ER and then they require a lot more care.  So, they send nurses at home to check bandages, general healthcare, vital signs, give them meds if need be, etc.

Ok, either I'm confused (possible) or you and Meri are talking about entirely different types of programs.  What you're talking about sounds like some sort of in-home chronic care program, while Meri seems to be describing a program that provides emergency treatment.

[crazy canuck]

That sounds even more costly and inefficient than going to the ER, though more convenient (and probably quicker) for the patient.

For some vulnerable clients (chronical diseases, elderlys, etc), it is better this way, because they will often wait too long before going to the ER and then they require a lot more care.  So, they send nurses at home to check bandages, general healthcare, vital signs, give them meds if need be, etc.

Ok, either I'm confused (possible) or you and Meri are talking about entirely different types of programs.  What you're talking about sounds like some sort of in-home chronic care program, while Meri seems to be describing a program that provides emergency treatment.

Nurse practitioners can do both and depending on the nature of the visit required a doc might travel with them.  It does a lot to reduce expense.

[merithyn]

What cc said.

[The Minsky Moment]

Not just the tests. I'm baffled that you have to go to the doctor/hospital to get tested. They should come to you so as not to risk spread. Don't you guys have hotlines provided by your insurer/network/government?

We don't have a government at the moment, perhaps try back in early 2021?

You can call an insurance company, wait about 30 minutes, spend another five minutes entering codes, and then finally get a person who will say your aren't covered regardless of the question or what your coverage is.